Supplementary interventions

Patients may find that supplementary care helps them to cope with their diagnosis, treatment and the long-term effects of NSCLC

Over the course of disease, anti-cancer treatments should be supplemented with interventions that aim to prevent the complications of disease and treatment, and to maximise your quality of life. These interventions may include supportive, palliative, survivorship and end-of-life care, which should all be coordinated by a multidisciplinary team (Jordan et al., 2018). Ask your doctor or nurse about which supplementary interventions are available; you and your family may receive support from several sources, such as a dietician, social worker, priest or occupational therapist.

Supportive care

Supportive care involves the management of cancer symptoms and the side effects of therapy. There is a range of therapies available that can help with the management of NSCLC. These include bone modifying agents (e.g. zoledronic acid and denosumab, used to reduce the occurrence of fractures commonly associated with the presence of bone metastases), stents (for relieving major airway obstructions that can cause dyspnoea), pain management and nutritional support (Planchard et al., 2018). Generally, early supportive care is recommended in parallel with treatments for the cancer itself: it may improve your quality of life and mood and lessen the need for aggressive treatment (Planchard et al., 2018).

Palliative care

Palliative care is a term used to describe care interventions in advanced disease, including the management of symptoms as well as support for coping with prognosis, making difficult decisions and preparation for end-of-life care. Palliative care in advanced lung cancer may include treatment for pain, airway obstructions and bedsores.

Survivorship care

Support for patients surviving cancer includes social support, education about the disease and rehabilitation. For example, psychological support can help you to cope with any worries or fears. Patients often find that social support is essential for coping with the cancer diagnosis, treatment and the emotional consequences. A survivor care plan can help you to recover wellbeing in your personal, professional and social life. For further information and advice on survivorship, see ESMO’s patient guide on survivorship (http://www.esmo.org/Patients/Patient-Guides/ Patient-Guide-on-Survivorship).

End-of-life care

End-of-life care for patients with incurable cancer primarily focusses on making the patient comfortable and providing adequate relief of physical and psychological symptoms, for example palliative sedation to induce unconsciousness can relieve severe pain, dyspnoea, delirium or convulsions (Cherny, 2014). Discussions about endof-life care can be very distressing, but support should always be available to you and your family at this time.